What Is Hip Osteoarthritis?
Hip osteoarthritis is the progressive loss of joint cartilage with bony changes (osteophytes) leading to pain, stiffness, and loss of function. It commonly affects adults over 50, but younger people may develop OA after conditions such as femoroacetabular impingement (FAI), dysplasia, Perthes disease, or previous injury.
Our approach: clarify the diagnosis, start a structured non-operative programme, and consider surgery at the right time with a focus on faster, safer recovery.
Symptoms & Red Flags
Typical Symptoms
- Deep groin pain that may radiate to the thigh, buttock, or knee
- Morning stiffness or stiffness after sitting
- Pain with weight-bearing: walking, stairs, getting in/out of a car
- Reduced range of motion, especially internal rotation
- Sleep disturbance from night pain
Red Flags (Urgent Review)
- Sudden severe hip pain after a fall
- Fever or feeling unwell (possible infection)
- Rapidly worsening pain with inability to bear weight
- History of cancer, unexplained weight loss, or night pain
Diagnosis & Imaging
We begin with a detailed history and examination, assessing gait, leg length, and hip motion, and ruling out referred pain.
Imaging
- X-ray: first-line to confirm OA (joint-space narrowing, osteophytes, subchondral changes).
- MRI: not routinely required for typical OA; helpful when symptoms and X-rays do not match, or to assess avascular necrosis, occult fracture, or labral pathology.
- Ultrasound: primarily for guided injections rather than diagnosis.
Conditions We Exclude
- Trochanteric bursitis / gluteal tendinopathy (lateral hip pain)
- Lumbar spine–related pain (sciatica, spinal stenosis)
- Inguinal/abdominal pathology and referred knee pain
Non-Surgical Treatment (What Works)
Education & Activity Modification
We explain the condition and teach pacing, joint-load management, and practical strategies—using a stick on the opposite side, modifying hills/stairs, and planning rest breaks—to reduce pain without stopping movement.
Targeted Exercise Therapy
- Progressive strengthening (gluteals, abductors, core)
- Low-impact aerobic work (walking, cycling, aquatic exercise)
- Neuromuscular control & balance drills
- Mind–body options (Tai Chi, yoga) for flexibility and symptom control
Our physiotherapists coordinate programmes pre- and post-surgery and liaise with your local physio for continuity of care.
Weight Management & Metabolic Health
Even modest weight loss reduces hip joint load and improves pain scores. We partner with your GP and, when needed, a dietitian to optimise nutrition, sleep, and activity—also reducing surgical risk if a hip replacement is required.
We typically structure conservative care over 6–12 weeks, track outcomes (pain, function, walking tolerance), and adjust the plan as you progress.
Pain Relief & Medications
- Paracetamol: reasonable short trial; stop if ineffective.
- Oral NSAIDs / COX-2 inhibitors (e.g., ibuprofen, naproxen, celecoxib): effective for many when used cautiously—consider stomach, kidney, and cardiovascular risks.
- Topical NSAIDs: adjunct option, especially for superficial joints (less evidence for deep hip).
- Opioids: generally not advised for chronic OA pain except short-term in select cases under close supervision.
Safety tip: Track total daily dose when using combination products to avoid paracetamol overdose, and discuss regular NSAID use with your GP.
Image-Guided Injections
- Corticosteroid: can provide short-term pain relief to enable rehab or manage flares.
- Hyaluronic acid: mixed evidence in the hip; discussed case-by-case.
No injection reverses arthritis; we use them selectively to support your broader treatment plan.
When to Consider Hip Replacement
Surgery becomes appropriate when:
- Severe pain limits walking, sleep, work, or daily activities
- A structured programme of non-operative care has been attempted
- X-rays confirm moderate–severe OA and other causes are excluded
- You are medically optimised and motivated for rehabilitation
What Hip Replacement Achieves
Most patients experience substantial pain relief and improved function. We use evidence-based implant selection and Enhanced Recovery After Surgery (ERAS) pathways for quicker, safer discharge.
Our Surgical Pathway
- Anterior total hip replacement (muscle-sparing) when suitable
- Day-stay or short-stay options for selected patients
- Multimodal analgesia, early mobilisation, coordinated discharge
- Digital follow-up via the Patient Portal for secure messaging, instructions, and outcomes tracking
Pre-hab & Recovery Milestones
Pre-Surgery Optimisation
- Strength & conditioning for gluteals and core
- Cardiometabolic optimisation (weight, diabetes, blood pressure)
- Smoking cessation and alcohol moderation
- Medication review (blood thinners, supplements)
- Home readiness: railings, bed height, clear walkways
Recovery After Hip Replacement
- Day 0: stand and walk with a physiotherapist
- Week 1–2: transition off walking aids as safe
- Week 3–6: progress strengthening and balance; consider return to driving when you can perform an emergency stop safely and are off stronger pain medicines
- Week 6–12: normalise gait, increase endurance; many office workers return in this window
- Sport: cycling, swimming, golf, hiking; higher-impact goals discussed individually
Frequently Asked Questions
Do I need an MRI to diagnose hip OA?
Usually no. A well-taken X-ray confirms most cases. We use MRI when symptoms and X-rays do not align, or to assess conditions such as avascular necrosis or occult fracture.
What’s the difference between hip OA and trochanteric bursitis?
Hip OA causes deep groin pain with stiffness and reduced rotation. Bursitis typically causes lateral hip pain over the outer thigh, worse when lying on that side.
Do injections fix osteoarthritis?
No injection reverses arthritis. Corticosteroid injections can provide temporary relief to support exercise and activity. Suitability depends on your health profile and goals.
How long do hip replacements last?
Modern implants have excellent long-term survivorship in Australian registry data. Outcomes continue to improve through ongoing monitoring and evidence-based implant selection.
Should I stop exercising?
No. Guided, low-impact exercise is central to managing hip OA and is recommended by current guidelines. We tailor mode and volume to your symptoms and goals.
Why Choose Us for Hip Osteoarthritis Care?
- Specialist diagnosis to clarify the true source of pain
- Joined-up care: surgeon, physiotherapist, and GP working to one plan
- Evidence-based non-operative pathway and modern surgery when needed
- ERAS protocols for faster recovery and digital follow-up via the Patient Portal
- Clear outcomes tracking and education resources